Fludarabine phosphate in lymphoma: an important new therapeutic agent

McLaughlin, Peter; Robertson, L. E.; Keating, Michael J.

doi:10.1007/978-1-4615-4129-5_1

Cited by 18 publications

(17 citation statements)

References 29 publications

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“…Since the nucleoside analogues fludarabine (FAMP), 2-chlorodeoxyadenosine (2-CdA), and 2-deoxycoformycin (DCF) act in resting cells as well as in dividing cells (McLaughlin et al 1997;Fridrik et al 1998;Honma and Niitsu 2000), these substances have gained increasing importance in the treatment of NHL.…”

Section: Introductionmentioning

confidence: 99%

High rates of long-lasting remissions after 5-day bendamustine chemotherapy cycles in pre-treated low-grade non-Hodgkin's-lymphomas

Bremer

2002

Journal of Cancer Research and Clinical Oncology

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Bendamustine proved to be very effective in pre-treated low-grade NHL patients by inducing high rates of long-lasting remissions. Bendamustine combines the pharmacological properties of an alkylating agent with those of a purine analogue and showed no cross-resistance to chlorambucil, melphalan, cyclophosphamide, mitoxantrone, and other anthracyclines. The myelosuppressive toxicities were dose limiting, and the non-haematological side effects were moderate.

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Section: Introductionmentioning

confidence: 99%

High rates of long-lasting remissions after 5-day bendamustine chemotherapy cycles in pre-treated low-grade non-Hodgkin's-lymphomas

Bremer

2002

Journal of Cancer Research and Clinical Oncology

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“…In single-agent trials, interferon-α, the nucleoside analogues, fludarabine and 2-chlorodeoxyadenosine, and the chimeric anti-CD20 monoclonal antibody, rituximab, have all demonstrated response rates of 40%-50% [33][34][35][36]. These encouraging single-agent results have led to the incorporation of these agents into combination programs.…”

Section: New Treatment Options…better Results?mentioning

confidence: 99%

Progress and Promise in the Treatment of Indolent Lymphomas

McLaughlin

2002

The Oncologist

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In the era of conventional alkylating agent-based chemotherapy, advanced stage indolent lymphoma has been considered incurable. The failure of our traditional therapies to cure these patients, coupled with the indolent course of the disease and the elderly population affected, has fostered a nihilistic attitude about the treatment of these diseases. Twenty years ago, in the absence of interesting alternatives to alkylating agents, judicious use and reuse of alkylators was perhaps the best we could do. There are now many reasons for optimism and excitement in the treatment of these diseases, including the availability of promising agents such as interferon-α, the nucleoside analogues, and rituximab. Radioimmunotherapy will also likely play a role in future therapy programs. Allogeneic stem cell transplantation is a high-risk approach that is not an option for all patients, but it has the potential to cure patients, even in the setting of relapse. Mini-allogeneic transplantation may permit an approach to allogeneic transplantation that is better tolerated than standard transplant strategies. In addition to these therapy options, biological insights have provided new options for monitoring patients. Molecular monitoring (polymerase chain reaction for bcl-2) is a stringent measure of short-term treatment efficacy, and one that correlates with durability of remission, i.e., it is a surrogate marker by which to judge treatment efficacy. There used to be a limited number of conventional treatment approaches, which consistently failed. The pendulum has swung. There are now many promising new options. It is time to plan and conduct trials that are geared for success. The

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“…In Germany, older patients (> 65 years) with stage III or IV lymphoma who are not treated in clinical studies commonly receive 6 cycles of CHOP chemotherapy (doxorubicin, vincristine, cyclophosphamide, prednisolone), 4 or 6 cycles of the purine analogue fludarabine, or 4 infusions of the monoclonal antibody rituximab. Remission rates and remission duration in patients with relapsed follicular NHL are described as being comparable in all 3 regimens [3,4]. Whilst the various regimens are equally effective, they differ quite considerably with regard to toxicity.…”

Section: Introductionmentioning

confidence: 95%

“…Whilst the various regimens are equally effective, they differ quite considerably with regard to toxicity. A CHOP chemotherapy regimen can induce all the characteristic adverse events of a cytostatic therapy, and fludarabine also has an immunosuppressive effect [3]. The rate of adverse effects of rituximab is low [4].…”

Section: Introductionmentioning

confidence: 99%

Sensitivity Analysis of Cost Factors for Various Therapy Options in the Treatment of Follicular Lymphoma

Schmitz

Aly²,

Steinmetz³

et al. 2006

Oncol Res Treat

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Background: In Germany, patients with relapsed follicular non-Hodgkin’s lymphoma do not all receive the same treatment. In this study, 3 therapy regimens were analyzed which were considered to be similar. With the goal of determining the treatment option with the lowest direct costs whilst maintaining the same degree of effectiveness, a cost analysis model was established and applied by way of example to the existing illness constellation. Methods: The German doctors’ fee scale (Einheitlicher Bewertungsmaßstab, EBM) valid until 2005 served as the basis for the calculation of medical services within the scope of the present statutory health insurance guidelines. A virtual standard patient was constructed for the cost model and treated with the different therapy regimens. The incidences of individual adverse events described in literature served as the basis for the characterization of the average toxicity of the respective treatment methods. Result: The overall costs result from the sum of the treatment costs and the toxicity-related costs. The effect of additional interventions on the overall cost was also examined. Conclusion: Whereas the accompanying documentation of costs in clinical studies is organizationally complex and very tedious, the model applied here offers a reliable method of quantifying the costs of the different therapy regimens. It permits the comparison of different treatment alternatives, and it enables, by means of a cost variance analysis, the identification of cost drivers and less expensive measures within a therapy method.

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Fludarabine phosphate in lymphoma: an important new therapeutic agent

Cited by 18 publications

References 29 publications

High rates of long-lasting remissions after 5-day bendamustine chemotherapy cycles in pre-treated low-grade non-Hodgkin's-lymphomas

High rates of long-lasting remissions after 5-day bendamustine chemotherapy cycles in pre-treated low-grade non-Hodgkin's-lymphomas

Progress and Promise in the Treatment of Indolent Lymphomas

Sensitivity Analysis of Cost Factors for Various Therapy Options in the Treatment of Follicular Lymphoma

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